This paper presents the results of research conducted in Accra, Ghana, aimed at understanding how access to water allows small-scale, water-dependent livelihoods to contribute to the household income of urban and peri-urban communities. Ten communities were selected in Accra and its surrounding communities to reflect different levels of infrastructure provision and conditions of water supply. Focus group discussions were held in each community. Issues which emerged were investigated further in a structured household questionnaire survey involving 443 respondents. A wide range of small-scale water dependent occupations were observed. Among the households surveyed, 59.14 per cent were engaged in a water-dependent occupation which contributed over 80 per cent of household income in some cases. Small-scale, water-dependent occupations, thus, constitute an important source of income for urban and peri-urban households.